REHABILITATION SERVICES PROVIDER IN MONTANA

Fatumata Kaba
Aug 6
3 min read

SUPPORTING RECOVERY AND INDEPENDENCE THROUGH REHABILITATION SERVICES

Rehabilitation Services in Montana assist individuals with disabilities, injuries, or chronic conditions to improve their physical, cognitive, and social functioning. These services promote recovery, enhance independence, and support community integration. Rehabilitation Services are authorized under Montana Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Montana Department of Public Health and Human Services (DPHHS)

Role: Administers Medicaid waiver funding for Rehabilitation Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Developmental Disabilities Program (DDP) within DPHHS

Role: Oversees quality standards, service delivery, and compliance for Rehabilitation Services within HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)Role: Provides federal oversight ensuring Medicaid-funded Rehabilitation Services meet HCBS quality, person-centered planning, and participant protection standards.

2. REHABILITATION SERVICES OVERVIEW

Rehabilitation Services support individuals recovering from injuries, living with disabilities, or managing chronic conditions by providing therapeutic interventions and skill development.

Approved providers may deliver:

Physical Rehabilitation: Therapy to improve mobility, strength, and physical function.
Occupational Therapy: Assistance with daily living skills and functional tasks.
Speech-Language Therapy: Improving communication, swallowing, and cognitive skills.
Behavioral Rehabilitation: Addressing behavioral challenges and promoting adaptive skills.
Social and Community Integration: Facilitating community participation and social engagement.
Cognitive Rehabilitation: Enhancing memory, problem-solving, and independent living skills.

All rehabilitation services are customized to the participant’s Individualized Service Plan (ISP) and adhere to Medicaid waiver guidelines.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the Montana Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Rehabilitation provider via the Montana Medicaid Provider Enrollment Portal.
Maintain general liability and professional liability insurance.
Obtain applicable professional licenses (e.g., Physical Therapist, Occupational Therapist) as required by Montana state law.
Develop policies for rehabilitation planning, progress tracking, and service documentation.
Ensure staff meet health screenings, background checks, and relevant training requirements.

4. MONTANA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application through the Montana Medicaid Provider Enrollment Portal for Rehabilitation Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, professional licenses, insurance certificates, and staff qualifications.

Program Readiness Review:

DPHHS evaluates provider readiness, including staff credentials, therapeutic protocols, and safety procedures.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for Rehabilitation Services using designated billing codes.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (Montana Secretary of State)
IRS EIN confirmation
NPI confirmation
Professional licenses (e.g., PT, OT, Speech Therapy certifications)
Proof of general and professional liability insurance
Rehabilitation Services Policy & Procedure Manual, including:
- Assessment and therapy planning protocols
- Safety and risk management procedures
- Documentation standards and progress tracking
- Staff credentialing, training, and continuing education records
- HIPAA compliance and participant rights policies
- Medicaid billing practices and audit readiness